¶ … clients and their presenting problems are unique in some way, the 12 core functions of an addiction counselor can help guide the intervention and case management process. This paper provides an overview of these 12 core functions of addiction specialists, followed by a personal interpretation of their meaning. In addition, a case summary of a young male adult, "David" who suffers from drug and alcohol addictions, is followed by an application of the first five of the 12 core functions of an addiction counselor to David's unique situation. Finally, a summary of the research and important findings concerning the 12 core functions of addiction counselors are provided in the conclusion.

Twelve Core Functions of an Addictions Counselor

Addiction counselors are consulted by people from all walks of life, suffering from the entire continuum of substance abuse problems as well as an array of legal and privacy issues that must be taken into account in formulating treatment plans (Morgan & Miller, 2012). The treatment planning process can be facilitated, though, by following the 12 core functions of an addiction counselor (Miller, 2010). The 12 core functions of an addiction counselor identified by Herdman (2001) are set forth and defined in Table 1 below followed by a personal interpretation of their respective meanings.

Table 1

The 12 Core Functions of an Addictions Counselor

Core Function

Description

Screening

The process by which the client is determined appropriate and eligible for admission to a particular program.

Intake

The administrative and initial assessment procedures for admission to a program.

Orientation

Describing to the client the following: general nature and goals of the program; rules governing client conduct and infractions that can lead to disciplinary action or discharge from the program; in a non-residential program, the hours during which services are available; treatment costs to be borne by the client, if any; and client rights.

Assessment

The procedures by which a counselor/program identifies and evaluates an individual's strengths, weaknesses, problems, and needs for the development of a treatment plan.

Treatment Planning

The process by which the counselor and client identify and rank problems needing resolution; establish agreed upon immediate and long-term goals; and decide upon a treatment process and the resources to be utilized.

Counseling

The utilization of special skills to assist individuals, families, or groups in achieving objectives through exploration of a problem and its ramifications, examination of attitudes and feelings; consideration of alternative solutions; and decision-making.

Case Management

Activities which bring services, agencies, resources, or people together within a planned framework of action toward the achievement of established goals. It may involve liaison activities and collateral contacts.

Crisis Intervention

Those services which respond to an alcohol and/or other drug abuser's needs during acute emotional and/or physical distress.

Client Education

Provision of information to individuals and groups concerning alcohol and other drug abuse and the available services and resources.

Referral

Identifying the needs of a client that cannot be met by the counselor or agency and assisting the client to utilize the support systems and community resources available.

Report and Record Keeping

Charting the results of the assessment and treatment plan, writing reports, progress notes, discharge summaries and other client-related data.

Consultation

Relating with in-house staff or outside professionals to assure comprehensive, quality care for the client.

Source: Herdman (2001)

Drawing on appropriate diagnostic criteria, the screening function is used to make the evaluation concerning whether an individual is suitable and eligible for a given intervention or program, and if so, what type of intervention or program is most appropriate (i.e., inpatient, outpatient, residential, etc.). Some of the issues that should be taken into account during this core function include client's physical and psychological condition, what types of resources are available and the agency's guiding philosophical approach (Herdman, 2001). In many cases, screening is facilitated by easily ascertained criteria such as age, location of residence, gender, veteran status, income level and the source of the referral (Herdman, 2001).

As an extension of the screening function, the intake function is used to formalize the admission process of clients into the selection program or intervention, including obtaining informed consent from clients, coordinating payment, and generally completing all of the forms necessary to admit clients into treatment and for the assignment of a primary counselor (Herdman, 2001). By contrast, the orientation function is used to provide clients with the information, including the hours of availability of services, relevant rules, regulations and expectations, they need in order to navigate their way through unfamiliar treatment territories. In addition, the orientation function is used to familiarize clients with a description of their interventions and how they operate (Herdman, 2001). This function can be performed individually or in group or family settings.

As the term connotes, the assessment function is used to evaluate clients' individual attributes, including strengths and weaknesses and personal needs and problems in light of the selected intervention or treatment plan. While this function is typically performed early on in treatment, it is an ongoing evaluation process (Herdman, 2001). Based on the assessment, the next function, treatment planning, is used to codify mutually agreed upon treatment plans suitable for the client's needs. Immediate and long-term goals are established, with corresponding strategies for accomplishing each, including specifics concerning the responsible providers and the frequency of service delivery (Herdman, 2001). Like the assessment function, the treatment planning function is also an ongoing process (Herdman, 2001).

During the counseling function, practitioners apply specialized skills to help their clients achieve their treatment goals through careful analysis of problem areas and their implications as well as the clients' perception of these issues as they relate to their personal lives. The counseling function may involve a number of different therapeutic modalities and the counselor must be able to justify their use. Finally, developing a therapeutic rapport is an essential part of the counseling process.

The next addiction counselor function, case management, involves coordinating and focusing the available resources on achieving established treatment goals. This function may require collaboration with other agencies and treatment professionals and the rationale in support of a given case management approach must also be justifiable to clients. In many instances, case management will require coordination between a multidisciplinary treatment team in order to be effective.

The crisis intervention function is an as-needed process that is used to respond to clients' episodic substance abuse-related crises. The need for this function will vary depending on the types of comorbidities and emotional issues that are part of clients' constellation of symptoms and may require different interventions over time. As Miller (2010) points out, "Mental health problems may coexist with the addiction problem or be solely present in the client (alcohol/drug use masks the real problem, which is a mental health diagnosis)" (p. 22). Client education, the next addiction counselor function, involves providing clients with the information they need concerning the substances they are abusing in order for them to move beyond the contemplation stage to making firm decisions to change their behaviors. The type of client education needed is contextual and will vary according to treatment setting but may include a description of what resources are available, a step that is expanded upon during the referral function. During the referral function, addiction counselors provide clients with information concerning what resources are available to them and any potential limitations of each.

The penultimate function, report and record keeping, may sound like just so much paperwork, but its importance cannot be overstated. Addiction counselors may have dozens of clients at any given point in time, and it would be impossible for any individual to remember the precise details of each client's treatment plan and goals without careful written records. Maintaining accurate and timely records is not only an essential part of the treatment and case management process, it is also necessary in order to document success stories and failures to provide valuable lessons learned. For instance, according to Florin (2013), "Reports and record-keeping, or documentation, constitutes one of the 12 core functions identified for addiction counselors as part of our global criteria. It is listed right alongside counseling, case management and crisis intervention. Yet this function is often given only cursory attention" (p. 40). Moreover, this addition counselor function is frequently part of the process for the Joint Commission and other accrediting organizations, making the need for accurate and timely report and record keeping even more important. In this regard, Florin notes that, "This is part of the shifting climate in behavioral healthcare [and] agencies are being held accountable for implementing evidence-based practices that demonstrate results with their clients" (p. 41). In addition, effective report and record keeping can improve program accountability for organizational sponsors (Herdman, 2001).

The final addiction counselor function, consultation, requires counselors to recognize their limitations and specific roles within a multidisciplinary treatment team and forming networks of healthcare professionals that can help clients achieve their treatment plan goals. Although in-house practitioners are usually consulted first, outside consultations are also frequently required (Herdman, 2001).

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